mHealth in the developing world: Is it effective?

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The use of mobile communication technology has been shown to improve access to health services and medical information, but two systematic reviews published in PLoS Medicine indicate a lack of evidence that mHealth is an effective solution to health challenges in the developing world.

Photo by kiwanja on Flickr, Creative Commons licenseThe majority of studies on mHealth effectiveness are conducted in industrialized countries and may not apply to low- and middle-income countries. According to the systematic reviews, three out of 75 trials that aimed to assess whether mobile technology interventions could improve health behavior or disease management were from developing countries.

Previous studies in sub-Saharan Africa have found mobile phone text messaging to improve adherence to HIV treatment, while others have shown their failure to do so. The new reviews found that for disease management, the only two mHealth applications with sufficient evidence of benefit are ones related to adherence to antiretroviral therapy and smoking cessation.

The reviews call for additional rigorous mHealth tests in low- and middle-income settings.

1. Free C, Phillips G, Galli L, et al. The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review. PLoS Medicine 2013; 10(1): e1001362. (open access)
2. Free C, Phillips G, Watson L, et al. The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis. PLoS Medicine 2013; 10(1): e1001363. (open access)
3. Tatalovic M. “Evidence lacking on mHealth effectiveness in poor countries.” SciDevNet: 15 Jan 2013.

Motivating HIV testing among MSM using internet and mobile phones

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Men who have sex with men (MSM) have the highest HIV prevalence in Peru, yet they are underserved by traditional preventive programs. In Peru, the Internet and mobile phones have emerged as an effective and convenient tool to reach this population. A study published in PLoS ONE identifies five key themes that should be considered when designing an effective campaign to motivate HIV testing.

  1. Overcome fear of getting tested for HIV. Previous studies identify “fear of the consequences of a positive test result” as the main barrier for not getting tested among MSM. Since the 1980s, HIV testing campaigns in Peru have focused on fear, stigmatizing the disease and causing people to avoid getting tested out of fear of being positive. Future campaigns need to counteract this by providing motivational messages that transmit calmness and explain that HIV is now a chronic and treatable disease.
  2. Increase risk perception. MSM with high-risk practices often do not perceive themselves at risk. A brief explanation on the modes of transmission along with messages that can prompt participants to remember common risk situations they may have experienced would be useful to better understand the risks.
  3. Explain logistics. A successful campaign should include the marketing of the personnel, the place, information about the process, including the test itself, and the price of testing. The personnel include the professionals who will perform the HIV test and who will provide the results. The place includes the physical location where the test will be conducted, the operating hours, general attractiveness, comfort and accessibility. The price refers not only to monetary cost but also intangible costs such as embarrassment and psychological strain.
  4. Avoid stigmatizing and stereotyping content. Avoid language that implies gay men are promiscuous or more likely to have HIV. Use neutral characters (not stereotyped caricatures of gay men), as well as neutral language (absence of gay-related jargon) because either they were considered stigmatizing for gay-identified MSM, or because they will not feel identified within the heterosexually-identified MSM.
  5. Use appropriate layout and language. Study participants recommended that all text based information, when possible, should always be presented with images. Language should be simple and colloquial but not vulgar. The Layout should avoid the use of red, dark or gloomy colors. When possible, use humor because it makes information easier to understand and to remember.

These results serve as the basis to design an effective campaign to motivate HIV testing among gay and non-gay identified MSM in Lima, Peru, the study concludes.

1. Blas MM, Menacho LA, Alva IE, et al. Motivating Men Who Have Sex with Men to Get Tested for HIV through the Internet and Mobile Phones: A Qualitative Study. PLoS ONE 2013; 8(1): e54012. (open access)

Open access journals have same scientific impact as subscription journals

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A recent blog post on the BioMed Central Blog spotlights the scientific merits of open access literature and debates the question of who should pay for scientific publishing.

In recent months, the U.S. Congress has reviewed legislation on both sides: the Research Works Act (designed to block the National Institutes of Health’s Public Access Policy) and the Federal Research Public Access Act (requires that all research should become open access regardless of how it is published within six months of publication). A report released in the UK in June 2012 wholeheartedly backs the open access movement.

Additionally, BMC Medicine has published an article which compared the scientific impact of both open access and traditional pay per view publishing and found that both of these types of publishing produced high quality peer reviewed articles.

1. Bjork B-C, Solomon D. Open access versus subscription journals: a comparison of scientific impact. BMC Medicine 2012; 10: 73. (open access)

Open Access Week 2011

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Open Access Week 2011, the annual event celebrating the global movement towards open access to research and scholarship, runs this year from October 24-30. The event provides an opportunity to learn about the benefits of open access, share new ideas and strategies, and inspire wider participation in establishing open access as the norm in scholarly communication.

Open Access Week has served as a launching pad for new open access publication funds, open access policies, and papers reporting on the societal and economic benefits of open access.

Participation in this highly successful event continues to grow. This year, there are over 2,000 individuals in more than 110 countries registered in the Open Access Week social network. Participation remains strong throughout Europe and North America and will be complemented by new activities in regions as diverse as Algeria, Gambia, Iceland, Iraq, and Sudan. The global nature of this event is captured by an interactive Open Access Week member map.

Learn more by visiting the Open Access Week website.

Health eVillages

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Health eVillages is a new health care and human rights advocacy consortium which aims to bring mobile medical reference and decision support technology to clinicians fighting to save lives in underserved regions worldwide. Health eVillages will be assisting health care professionals practicing medicine in the most challenging clinical environments, by providing them with mobile clinical reference and decision support tools for medical training, diagnostics and clinical references.

Health eVillages is comprised of leading international health care advocacy organizations, mobile health care solution providers, health information technology companies, communication providers and public health foundations. They will provide health care professionals in disadvantaged areas with new and refurbished mobile phones and handheld devices that do not require internet access and are preloaded with clinical decision support reference tools, to ensure caregivers and patients have safe access to updated medical references in remote locations. All devices include drug guides, medical alerts, journal summaries and references from over 50 medical publisher’s resources.

Health eVillages is a collobaration between Physician’s Interactive and the Robert F. Kennedy Center for Justice and Human Rights.

Click here to learn morea bout Health eVillages.

Open Access Africa 2011

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Open Access Africa 2011, now in its second year, will once again bring together researchers, librarians and funding bodies to discuss the benefits of open access publishing in an African context.

Hosted by BioMed Central, in partnership with Computer Aid International, Open Access Africa 2011 will take place at Kwame Nkrumah University Of Science And Technology (KNUST) in Kumasi, Ghana, from 25-26 October 2011.

Speakers at this free event include representatives from Google, BMJ and Pan African Medical Journal. A full list of speakers can be accessed from the Open Access Africa 2011 website.

English language editing company, Edanz, will run a free pre-conference workshop on 24 October providing an introduction to their training program and online materials designed to address publishing challenges faced by non-native English speakers.

The conference is free to attend but registration will be necessary. For more information visit the Open Access Africa 2011 website or email

Top countries with the most open access journals

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Open access is a means to make research results freely available online to anyone. The unrestricted online access to articles published in scholarly journals is essential in order to ensure the rapid and efficient communication of the latest health research findings.

The following are the top 10 countries with the most open access journals in the Directory of Open Access Journals (DOAJ). Click here to view the complete list of countries with open access journals in DOAJ.

Top 10 countries with the most open access journals in DOAJ

  1. United States          1229
  2. Brazil                           592
  3. United Kingdom     509
  4. Spain                           367
  5. India                           317
  6. Germany                   212
  7. Canada                       205
  8. Romania                   178
  9. Italy                            171
  10. Turkey                       162

Delivering sexual health promotion to young people via text messaging

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Texting is an effective way to educate young people about sexual health

Mobile phones, in particular text messaging, offer health promoters an exciting opportunity to engage personally with a huge number of individuals for low cost. Young people in an Australian study viewed text messages as an acceptable and “personal” means of sexual health promotion, particularly valuing the informal language.

Study participants preferred messages that were positive, relevant, short and that covered a variety of topics. They were more likely to remember and share messages that were funny, rhymed and/or tied into particular annual events. The message broadcasting, generally every two weeks on Friday afternoons, was viewed as appropriate. Participants said the messages provided new information, a reminder of existing information and reduced apprehension about testing for sexually transmitted infections.

“As text messages continue to be used not only for health promotion, but also for other health-related functions such as disease self-management, appointment reminders, results of diagnostic testing and partner notification, it is critical to understand the factors that influence such intervention’s success,” the study said. “Beyond SMS [texting], understanding these factors is also relevant to other areas that could be exploited for health promotion purposes, such as updates on social networking sites, where concise formats are also required.”

1. Gold J, Lim MSC, Hellard ME, et al. What’s in a message? Delivering sexual health promotion to young people in Australia via text messaging. BMC Public Health 2010; 10: 792. (open access)

HIV/AIDS education improved by digital audio technology

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An HIV/AIDS education program implemented in rural Nigeria that incorporated digital audio technology and was tailored to the culture and language of the community may provide a feasible and cost-effective alternative to improving HIV/AIDS knowledge in low-literacy rural settings.

A study, which compared the technology-assisted program to a conventional seminar/pamphlet-based program, was published in the journal BMC International Health and Human Rights.

The audio device-assisted intervention was associated with more improved HIV/AIDS knowledge among participants than the conventional approach of educating the public through seminars and pamphlet distribution, the study found.


1. Ofotokun I, Binongo JNG, Rosenberg ES, et al. Culturally-adapted and audio-technology assisted HIV/AIDS awareness and education program in rural Nigeria: a cohort study. BMC International Health and Human Rights 2010; 10: 2. (open access)